- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $15.14 / $39.81
| Facility | | $5.01 | $15.14 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $7.08
| Professional | | $5.01 | $5.01 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $28.84
| Facility | | $6.76 | $6.76 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.39 / $5.25
| Professional | | $3.39 | $3.39 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $26.92 / $40.74
| Professional | | $16.98 | $26.92 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $17.78 / $30.90
| Facility | | $6.92 | $17.78 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.01 / $12.02
| Professional | | $3.72 | $5.01 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.13 / $10.00
| Professional | | $6.76 | $8.13 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $11.48 / $13.18
| Professional | | $5.62 | $11.48 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.41 / $7.41
| Facility | | $6.03 | $7.41 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.46 / $14.45
| Professional | | $6.03 | $6.46 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $9.77 / $10,000.00
| Facility | | $5.25 | $9.77 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $9.77 / $10,000.00
| Professional | | $5.25 | $9.77 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $6.76 / $11.75
| Facility | | $2.88 | $6.76 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $3.55 / $6.76
| Professional | | $2.88 | $3.55 | $6.76 |